Wiki OBGYN Delivery Coding Question

[jessmtxstate]

A patient was 22 weeks pregnant and had to terminate the pregnancy due to multiple fetal anomalies; my physician delivered the fetus vaginally in the hospital. The patient was only seen 3 times in our office for prenatal care. The physician wants me to bill out CPT 59400 (routine obstetric care including antepartum care, vaginal delivery, and postpartum care). I think we should bill out the appropriate E\M code for the three office visits and 59409 (vaginally delivery only). If anyone out there has any comments or advice to share with me I would great appreciate it.

 

[shieldsa]

Some payers have a specific number of prenatal visits they require to bill 59400. However, I agree and would break out the prenatal visits as E&Ms and bill 59409. You can add modifier 22 to 59409 because of the early gestational age and the fetal anomalies.